Case Management

Prime Health offers full medical case management geographically
based on the needs of our clients. Through our experienced team of
Case Management nurses, our focus is to ensure the highest quality
of care for the injured worker. Our dedicated nurses proactively
use in-network providers to treat the injured workers. Accessing
in-network providers assist in the ability to achieve earlier
return to work and maximum savings on the total claim as well as
accountability based on the guidelines set in the contract between
the provider and the PPO Network.

Our Case Management program adheres to the Commission for Case
Manager Certification (CCMC) guidelines, holding our nurses to the
highest standards of ethics. Our dedication is to provide our
clients with the highest quality of managed care solutions.

Field Case Management is designed to facilitate
in the assurance of high quality medical care and early
intervention to impact the total cost of the claim. Services
provided are:

Evaluation of medical care and coordination with the treating
physician, employer, and insurance carrier.

Early intervention for immediate cost control

Measurement of the injured workers' capabilities in order to
support return to work

Communication between the adjuster on activities involving the
injured worker to ensure continuity of care

Assist provider panel development as our nurses are locally
based with knowledge and ability to obtain optimal care

Telephonic Case Management begins immediately
after the injury as an early intervention for faster and
appropriate treatment for the injured worker. Our committed
telephonic case managers work to ensure that medically appropriate
care is provided to claimants while focusing on reducing overall
medical and indemnity costs.